Oestrogen dermatitis

A 56-year-old woman presented with a recurrent itchy eruption mainly involving her face and upper trunk for 5 years. The rash flared cyclically 3 days before her menstruation and improved 5-10 days after the onset of her period. Examination revealed erythematous maculopapules, vesicles and crusting mainly on her face and upper trunk. Biopsy from a papule revealed spongiotic dermatitis. Intradermal testing with oestrogen was positive. There was marked improvement with tamoxifen. Sensitivity to oestrogen and progesterone is rare in women and the clinical presentation may be similar. Positive intradermal testing is diagnostic. Tamoxifen is effective in treating oestrogen sensitivity.